Faculty Collaboration Database

DAILY INPATIENT GLYCEMIC SURVEY (DINGS): A PROCESS TO REMOTELY IDENTIFY AND ASSIST IN THE MANAGEMENT OF HOSPITALIZED PATIENTS WITH DIABETES AND HYPERGLYCEMIA. Endocr Pract 2015 Aug;21(8):927-35

Date

06/30/2015

Pubmed ID

26121456

DOI

10.4158/EP14577.OR

Scopus ID

2-s2.0-84979822664 (requires institutional sign-in at Scopus site)   21 Citations

Abstract

OBJECTIVE: Hyperglycemia, hypoglycemia, and glycemic variability have been associated with increased morbidity, mortality, and overall costs of care in hospitalized patients. At the Stratton VA Medical Center in Albany, New York, a process aimed to improve inpatient glycemic control by remotely assisting primary care teams in the management of hyperglycemia and diabetes was designed.

METHODS: An electronic query comprised of hospitalized patients with glucose values <70 mg/dL or >350 mg/dL is generated daily. Electronic medical records (EMRs) are individually reviewed by diabetes specialist providers, and management recommendations are sent to primary care teams when applicable. Glucose data was retrospectively examined before and after the establishment of the daily inpatient glycemic survey (DINGS) process, and rates of hyperglycemia and hypoglycemia were compared.

RESULTS: Patient-day mean glucose slightly but significantly decreased from 177.6 ± 64.4 to 173.2 ± 59.4 mg/dL (P<.001). The percentage of patient-days with any value >350 mg/dL also decreased from 9.69 to 7.36% (P<.001), while the percentage of patient-days with mean glucose values in the range of 90 to 180 mg/dL increased from 58.1 to 61.4% (P<.001). Glycemic variability, assessed by the SD of glucose, significantly decreased from 53.9 to 49.8 mg/dL (P<.001). Moreover, rates of hypoglycemia (<70 mg/dL) decreased significantly by 41% (P<.001).

CONCLUSION: Quality metrics of inpatient glycemic control improved significantly after the establishment of the DINGS process within our facility. Prospective controlled studies are needed to confirm a causal association.

Author List

Mendez CE, Ata A, Rourke JM, Stain SC, Umpierrez G

Author

Carlos Eduardo Mendez Castrillo MD Associate Professor in the Medicine department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Aged
Blood Glucose
Diabetes Mellitus
Disease Management
Electronic Health Records
Female
Humans
Hyperglycemia
Hypoglycemia
Inpatients
Male
Middle Aged